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Benjamin A. Bassichis, MD; J. Regan Thomas, MD

Arch Facial Plast Surg. 2003;5:530-532.

Hemostasis and decreased risk of synechiae formation are benefits of nasal packing after sinus surgery; however, these must be weighed against the possible complications, which can include devastating toxic shock syndrome. Nasal packing is often impregnated with an ointment that allows for a less traumatic placement into and removal from the nasal cavity, as well as providing some antibiotic coverage for nasal bacterial flora. Orbital complications secondary to the petroleum-based packing have been reported. When sinus surgery is performed in conjunction with a rhinoplasty, there is a possibility of petroleum ointment migrating into intranasal incisions or osteotomy sites. A 15-year-old girl was examined 1 year after endoscopic sinus surgery combined with an open rhinoplasty had been performed at another institution. Physical examination showed a widened nasal dorsum with an open-roof deformity and a 1-cm firm mass lateral to her lateral nasal sidewall. The pathological examination after removal of the cyst showed a foreign-body inclusion cyst or lipogranuloma. The cyst contained a petroleum-based substance.

From the Division of Facial Plastic Surgery (Dr Bassichis), Department of Otolaryngology–Head and Neck Surgery (Dr Thomas), University of Illinois at Chicago.